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Ismail AMA, Saad AE, Abd-Elrahman NAF, Elfahl AMA. Response of Lipid Profile to Laser Acupuncture along with Diet and Pilates Exercise in Obese Women with Systemic Lupus Erythematosus: a Randomized Controlled Trial. J Acupunct Meridian Stud 2023; 16:152-158. [PMID: 37609770 DOI: 10.51507/j.jams.2023.16.4.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/08/2023] [Accepted: 07/27/2023] [Indexed: 08/24/2023] Open
Abstract
Background Obesity-induced dyslipidemia is one of the main factors contributing to morbidity and mortality associated with metabolic syndrome, atherosclerosis, and coronary artery disease among patients with systemic lupus erythematosus (SLE). Objectives This research aimed to assess the effect of adding laser acupuncture therapy (LAT) to a Pilates exercise program (PEP) and low-calorie diet protocol (LCDP) on blood lipids among 60 obese women with SLE. Methods Study participants were women aged between 23 and 49 years, randomly assigned to one of two groups, A or B, each comprising 30 women. In addition to adherence to the LCDP, both groups were supervised five times weekly during 50-minute PEP sessions. Group A also received LAT three times weekly, with each session lasting 2 minutes on selected acupoints. After the 12-week intervention, plasma total cholesterol, high-density lipoprotein, triglycerides, and low-density lipoprotein were assessed. Results Both groups demonstrated significant improvement in the aforementioned lipids after the 12-week intervention. A comparison between the post-intervention values of the lipids in the groups revealed a significant improvement favoring group A (the group that received LAT). Conclusion Adding a 12-week LAT regimen to PEP and LCDP significantly improved lipid profiles among 60 obese women with SLE.
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Affiliation(s)
- Ali Mohamed Ali Ismail
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ahmad Elsayed Saad
- Department of Medical Biochemistry and Molecular Biology, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
| | - Noha Ahmed Fouad Abd-Elrahman
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Badr University in Cairo, Cairo, Egypt
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Nazari M, Shabani R, Hassanzadeh-Rad A, Esfandiari MA, Dalili S. Effect of concurrent resistance-aerobic training on inflammatory factors and growth hormones in children with type 1 diabetes: a randomized controlled clinical trial. Trials 2023; 24:519. [PMID: 37568220 PMCID: PMC10422817 DOI: 10.1186/s13063-023-07553-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Exercise training is a major factor in controlling type 1 diabetes mellitus (T1DM) in children. The present study aimed to assess the effect of concurrent resistance-aerobic training on selected inflammatory factors and hormones related to blood glucose homeostasis in children with T1DM. METHODS In this randomized controlled clinical trial, 40 children (with the mean age of 11.11 ± 2.29 years) were randomly assigned to an experimental (N = 20) or control group (N = 20). They underwent a 16-week training program, composed of concurrent resistance-aerobic training performed intermittently for 60 min three times a week. Before and after training, blood samples were analyzed for glucose homeostasis, selected inflammatory factors, and growth factors. Data were analyzed by paired t-test and analysis of covariance (ANCOVA) in IBM SPSS version 22. RESULTS The exercise training intervention reduced fasting blood sugar index (P = 0.002) and glycosylated hemoglobin significantly (P = 0.003). The growth hormone levels were increased significantly only in the experimental group (P = 0.037), whereas no significant difference was noted in the insulin-like growth factor-1 (P = 0.712). It was also found that interleukin-1β and high-sensitivity C-reactive protein did not change in the experimental or control group as compared to the pretest (P > 0.05). CONCLUSION As it was shown, it seems that concurrent resistance-aerobic training may improve blood glucose homeostasis and growth hormone. Therefore, these findings may suggest the benefit from exercise training of moderate intensity in children with T1DM. Besides, we recommend undertaking further clinical trials to determine if the exercise training was effective. TRIAL REGISTRATION This study was registered in the Iranian Registry of Clinical Trials under the code IRCT20150531022498N30: https://en.irct.ir/trial/41031 . Registered on July 26, 2019. All experiments on the participants were following the Declaration of Helsinki.
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Affiliation(s)
- Marzieh Nazari
- Faculty of Humanities, Rasht Branch, Islamic Azad University, Rasht, Iran
| | - Ramin Shabani
- Department of Exercise Physiology, Faculty of Humanities, Rasht Branch, Islamic Azad University, Rasht, Iran
| | - Afagh Hassanzadeh-Rad
- Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Ali Esfandiari
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Setila Dalili
- Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
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Cibinello FU, Caroliny de Jesus Neves J, Janeiro Valenciano P, Shizuko Fujisawa D, Augusto Marçal Camillo C. Effects of Pilates in children and adolescents - A systematic review and meta-analysis. J Bodyw Mov Ther 2023; 35:400-412. [PMID: 37330800 DOI: 10.1016/j.jbmt.2023.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/26/2023] [Accepted: 04/11/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Pilates can be performed by children as a form of exercise to promote healthy growth and development. The increasing use of Pilates as a type of exercise for children or as an adjunct tool in pediatric rehabilitation should be supported by evidence of its benefits. The aim of this systematic review and meta-analysis was to assess the effects of Pilates as an exercise prescription for children and adolescents. METHODS Five electronic databases were searched to identify trials (randomized controlled clinical trials or quasi-experimental studies) with a population of children or adolescents in which Pilates (mat or equipment) was performed as a form of exercise. Studies that investigated outcomes related to health and physical performance was analyzed. Individual trial effects were extracted and pooled for meta-analysis whenever possible. To evaluate the external and internal validity of the studies, we assessed their risk of bias. RESULTS Fifteen studies (from 945 records), including 1235 participants, met the eligibility criteria, and were included. The reported outcomes were heterogeneous, so only the effect on flexibility could be included in the meta-analysis (n = 4 studies). A significant positive trend toward improved flexibility for the control group compared with the Pilates group was found (Std. mean difference, 0.54; 95%CI: 0,18, 0.91; p = 0.003). CONCLUSION Few studies have assessed the effect of Pilates on children and adolescents. The lack of appropriate methodological descriptions/controls made it impossible to determine if all of the included studies were of good quality.
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Affiliation(s)
- Fabíola Unbehaun Cibinello
- Universidade Estadual de Londrina, Centro de Pesquisa e Pós-Graduação Av Robert Koch, 60, Vila Operária, Londrina, Paraná, Brazil.
| | - Jessica Caroliny de Jesus Neves
- Universidade Estadual de Londrina, Centro de Pesquisa e Pós-Graduação Av Robert Koch, 60, Vila Operária, Londrina, Paraná, Brazil
| | - Paola Janeiro Valenciano
- Universidade Estadual de Londrina, Centro de Pesquisa e Pós-Graduação Av Robert Koch, 60, Vila Operária, Londrina, Paraná, Brazil
| | - Dirce Shizuko Fujisawa
- Universidade Estadual de Londrina, Centro de Pesquisa e Pós-Graduação Av Robert Koch, 60, Vila Operária, Londrina, Paraná, Brazil
| | - Carlos Augusto Marçal Camillo
- Universidade Estadual de Londrina, Centro de Pesquisa e Pós-Graduação Av Robert Koch, 60, Vila Operária, Londrina, Paraná, Brazil
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Shorey S, Ng ED, Law EC, Wong JCM, Loke KY, Tam WWS. Physical Activity and Nutrition Interventions for Type 1 Diabetes: A Meta-analysis. Pediatrics 2022; 150:188758. [PMID: 35953465 DOI: 10.1542/peds.2022-056540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Current evidence is lacking on physical activity and nutrition-based interventions focusing on the management of type 1 diabetes mellitus (T1DM) and health-related quality of life among children. To assess the effects of physical activity interventions and nutrition-based interventions for children with T1DM. METHODS Data sources include the Cochrane Central Register of Controlled Trials, Medline, clinicaltrials.gov, the World Health Organization International Clinical Trials Registry Platform, CINAHL through January 2022. Study selection includes randomized controlled trials of children aged 18 years and below with T1DM comparing either a physical activity intervention, a nutrition-based intervention, or hybrid physical activity and nutrition-based intervention with placebo or no-treatment control. Data were pooled using a random-effects model. Primary outcomes were hemoglobin A1c (HbA1c), and health-related quality of life. RESULTS Eighteen trials were included. Physical activity compared with the no-treatment group showed a lack of effect on HbA1c (mean difference = -0.58, 95% confidence interval -1.20 to 0.05; P value = .07). Nutrition-based intervention compared with no-treatment control for HbA1c level revealed a lack of effect (mean difference = -0.61, 95% confidence interval -1.48 to 0.26; P value = .17). Limitations include paucity of studies and low quality of evidence caused by the risk of bias. CONCLUSIONS Despite the lack of significant evidence, the generally favorable results highlight the potential of such interventions in enhancing glycemic control and health-related quality of life. Additionally, promising results from a single physical activity-nutrition-based hybrid intervention in terms of glycemic control indicate the plausible effectiveness of a mixed intervention.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Center for Nursing Studies.,National University Health System, Singapore
| | | | - Evelyn C Law
- Departments of Pediatrics.,National University Health System, Singapore.,Translational Neuroscience Program, Agency for Science, Technology, and Research, Singapore Institute for Clinical Sciences, Singapore
| | - John C M Wong
- Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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García-Hermoso A, Ezzatvar Y, Huerta-Uribe N, Alonso-Martínez AM, Chueca-Guindulain MJ, Berrade-Zubiri S, Izquierdo M, Ramírez-Vélez R. Effects of exercise training on glycaemic control in youths with type 1 diabetes: a systematic review and meta-analysis of randomised controlled trials. Eur J Sport Sci 2022; 23:1056-1067. [PMID: 35659492 DOI: 10.1080/17461391.2022.2086489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractThe aim of the study is to evaluate whether exercise interventions are associated with improved glycaemic control in children and adolescents with type 1 diabetes mellitus (T1DM), and to examine its relationship with the characteristics of the intervention (i.e., type, intensity, length, and duration of the sessions). Eligible criteria were randomised controlled trials of youth aged 6-18 years with T1DM, participating in an exercise-based intervention where glycaemic control is measured (i.e., glycated haemoglobin [HbA1c]). Pooled effect sizes (Hedges'g) were calculated using random-effects inverse-variance analyses. Fourteen studies enrolling 509 patients were analysed. Effect size was expressed as Hedges' g to correct for possible small sample bias. Overall, HbA1c levels in the exercise group (g=-0.38 95% confidence interval [CI], -0.66 to -0.11; mean difference [MD]=-0.62%) were reduced compared with the control group. Concurrent training (g=-0.63 95%CI, -1.05 to -0.21), high-intensity exercise (g=-0.43 95%CI, -0.83 to -0.03), interventions ≥24 weeks (g=-0.92 95%CI, -1.44 to -0.40), and sessions ≥60 minutes (g=-0.71 95%CI, -1.05 to -0.08) showed larger changes (MD=-0.66% to 1.30%). In conclusion, our study suggests that programs longer than 24 weeks with at least 60 min/session of high-intensity concurrent exercise may serve as a supportive therapy to metabolic control in youth with T1DM.
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Affiliation(s)
- Antonio García-Hermoso
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Yasmin Ezzatvar
- Department of Nursing, Universitat de València, Valencia, Spain
| | - Nidia Huerta-Uribe
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Alicia M Alonso-Martínez
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | | | - Sara Berrade-Zubiri
- Pediatric Endocrinology Unit, Complejo Hospitalario de Navarra, IdiSNA, Pamplona, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
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Effectiveness of the Mat Pilates on the postural control, plantar pressure and plantar arch of school children: A randomized clinical trial. J Bodyw Mov Ther 2021; 28:576-584. [PMID: 34776199 DOI: 10.1016/j.jbmt.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 07/15/2021] [Accepted: 09/24/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of Mat Pilates on postural control, plantar pressure and plantar arch (ALM) in schoolchildren. DESIGN AND SETTING The study was a randomized clinical trial, developed at the Early Childhood Education Institute, Londrina-PR. The participants were randomly assigned to groups: Pilates Group (PG) and Control Group (CG). Patients in the CG did not perform extra physical activity (Interventions). PARTICIPANTS 43 children (eight to 12 years), no prior knowledge of the Pilates method, and no exercise training in the last six months. INTERVENTION The exercise program was based on the Mat Pilates method, twice weekly, 50 min each, 28 sessions. OUTCOME MEASURES Static balance (force platform), dynamic balance (the Reach Test), ALM (plantigraphy) and plantar pressure (baropodometry). The assessors were blinded to the allocation of participants. RESULTS Three children were excluded before randomization and 40 were randomized (PG n: 20; CG n:20).12 children were excluded during the protocol (PG n:7; CG n:5) and included in the intention to treat analysis. No significant difference between groups was observed for static and dynamic balance and ALM measures. There was a significant difference in the following outcomes for the PG: the plantar pressure on the right hemibody forefoot between pre-test 38.70 ± 14.38 and post-test 42.65 ± 15.63 (ES = 0.66; SRM = 0.50). The plantar pressure on the right hemibody rearfoot between pre-test 61.10 ± 14.18 and post-test 56.85 ± 19.39 (ES = 0.68; SRM = 0.53). No adverse or harmful events were reported in any group. CONCLUSION There were no differences in static and dynamic postural control and ALM between PG and CG. However, children GP showed improvement in some results of plantar pressure in relation CG. CLINICAL TRIAL REGISTRATION NUMBER Brazilian Registry of Clinical Trials (REBEC) (N_ RBR-8t5p7d).
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Chen Z, Ye X, Xia Y, Song H, Wang Y, Guan Y, Shen Z, Chen W, Jiang T, Wu H, Xu X. Effect of Pilates on Glucose and Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Physiol 2021; 12:641968. [PMID: 34135767 PMCID: PMC8202501 DOI: 10.3389/fphys.2021.641968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The benefits of Pilates for blood glucose and lipids remain unclear. The purpose of this study was to examine the effect of Pilates on their levels. Methods: Searches were conducted in five databases to identify relevant articles published until October 29, 2020. Paired reviewers independently screened the articles and extracted data from each included study. Meta-analysis was performed to assess the effects of Pilates on blood glucose and lipids. Subgroup analyses and sensitivity analyses were conducted to explore heterogeneity. Results: According to the inclusion and exclusion criteria, 15 randomized controlled trials (RCTs) comprising 587 participants were included in the study. Overall, the Pilates group (PG) had a significantly greater reduction in post-prandial blood glucose than the control group (CG) (MD = −22.25 mg/dL, 95% CI: [−28.34, 16.17] mg/dL, P < 0.00001, I2 = 0%); glycated hemoglobin (HbA1c) (MD = −0.78%, 95% CI: [−1.13, −0.42]%, P < 0.0001, I2 = 88%); total cholesterol (TC) (MD = −20.90 mg/dL, 95% CI: [−37.21, −4.60] mg/dL, P = 0.01, I2 = 84%); triglycerides (TG) (MD = −12.59 mg/dL, 95% CI: [−19.88, −5.29] mg/dL, P = 0.0007, I2 = 86%); and low density lipoprotein cholesterol (LDL-C) (MD = −12.39 mg/dL, 95% CI: [−16.82, −7.95] mg/dL, P < 0.00001, I2 = 45%) compared to CG, whereas no significant difference was detected between the two groups in fasting blood glucose (MD = −7.04 mg/dL, 95% CI: [−17.26, 3.17] mg/dL, P = 0.18, I2 = 93%), insulin (MD = −1.44 μU/mL, 95% CI: [−4.30, 1.41] μU/mL, P = 0.32, I2 = 0%); and high density lipoprotein cholesterol (HDL-C) (MD = −2.68 mg/dL, 95% CI: [−9.03, 3.67] mg/dL, P = 0.41, I2 = 89%). However, by subgroup analysis, we found that compared to the CG, PG showed no significant improvement in blood glucose and lipids levels for non-diabetics, while it presented a significantly greater decrease in post-prandial blood glucose, TC, TG, and LDL-C for diabetic patients. Notably, for diabetic patients, Pilates and medication treatments showed no significant reduction in fasting blood glucose (MD = −7.00 mg/dL, 95% CI: [−26.06, 12.06] mg/dL, P = 0.40) and HbA1c (MD = −0.23%, 95% CI: [−0.58, 0.13]%, P = 0.21, I2 = 0%) than medications treatment used alone, and Pilates combined with medications and dietary treatments presented no significant improvement in fasting blood glucose than a combination of medications and dietary treatments (MD = −10.90 mg/dL, 95% CI: [−32.35, 10.54] mg/dL, P = 0.32, I2 = 94%). Conclusions: Overall, Pilates could improve post-prandial blood glucose, fasting blood glucose, HbA1c, TG, TC, and LDL-C for diabetic patients, which could be influenced by its duration and intensity. Moreover, it had no significant effect on blood glucose and lipids for non-diabetic individuals. However, Pilates, as an adjunctive treatment to medications was not superior to medications used alone in lowering fasting blood glucose and HbA1c. Furthermore, Pilates combined with medications and dietary treatments showed no significant improvement in fasting blood glucose, whereas it had a greater reduction in post-prandial blood glucose and HbA1c for diabetic patients. Systematic Review Registration:https://osf.io/xgv6w.
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Affiliation(s)
- Zehua Chen
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangling Ye
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yubo Xia
- Kunming Municipal Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China
| | - Huiting Song
- Jiangxi Academy of Traditional Chinese Medicine, Nanchang, China
| | - Yi Wang
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yingxin Guan
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhen Shen
- Kunming Municipal Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China
| | - Weijian Chen
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Tao Jiang
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Huai Wu
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Xuemeng Xu
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
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Cibinello FU, de Jesus Neves JC, Carvalho MYL, Valenciano PJ, Fujisawa DS. Effect of Pilates Matwork exercises on posterior chain flexibility and trunk mobility in school children: A randomized clinical trial. J Bodyw Mov Ther 2020; 24:176-181. [PMID: 33218508 DOI: 10.1016/j.jbmt.2020.06.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/15/2020] [Accepted: 06/18/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the effects of an exercise program, based on the Pilates Matwork method, on posterior chain flexibility and trunk mobility in healthy school age children. DESIGN AND SETTING The study was a parallel-group randomized clinical trial. The participants were randomly assigned to groups: Pilates Group (PG) and Control Group (CG). The program was developed at the Early Childhood Education Institute, Londrina-PR. PARTICIPANTS 43 children with age between eight to 12 years, no prior knowledge of the Pilates method, and no exercise training in the last six months. INTERVENTION Four months of twice a week 50 min Pilates Matwork exercises were administered. OUTCOME MEASURES Flexibility and mobility, assessed using the sit-and-reach test, fingertip-to-floor test and photogrammetry. The assessors were blinded to the allocation of participants. RESULTS Three children were excluded before randomization and 40 were randomized (PG n = 20; CG n = 20).12 children were excluded during the protocol (PG n = 7; CG n = 5) and included in the intention to treat analysis. No significant difference between groups was observed for flexibility measures. There was a significant difference in the following outcomes for the PG: distance reached in the sit-and-reach test between pre-test (median 14.25[11.25-28.38]) and post-test (median 20.25[12.00-29.63]) (ES = 0.29, SRM = 0.73); Posterior angle of the knee in the fingertip-to-floor test between pre-test (median 191.60[187.20-191.60]) and post-test (median 189.00[185.90-191.50]) (ES = 0.56, SRM = 0.54). CONCLUSION There were no differences in posterior chain flexibility and trunk mobility between school age children who underwent Pilates Matwork exercises and the control. However, children who participated in the exercise program showed improvement in some results of flexibility. CLINICAL TRIAL REGISTRATION NUMBER Brazilian Registry of Clinical Trials (REBEC) (N° RBR-8t5p7d).
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Affiliation(s)
- Fabíola Unbehaun Cibinello
- Universidade Estadual de Londrina, CEPPOS - Centro de Pós-Graduação Professor Dr. Darli Antonio Soares, Av. Robert Koch, 60 - Vila Operária, Londrina, Paraná, Brazil.
| | - Jessica Caroliny de Jesus Neves
- Universidade Estadual de Londrina, CEPPOS - Centro de Pós-Graduação Professor Dr. Darli Antonio Soares, Av. Robert Koch, 60 - Vila Operária, Londrina, Paraná, Brazil
| | - Mônica Yosino Leão Carvalho
- Universidade Estadual de Londrina, CEPPOS - Centro de Pós-Graduação Professor Dr. Darli Antonio Soares, Av. Robert Koch, 60 - Vila Operária, Londrina, Paraná, Brazil
| | - Paola Janeiro Valenciano
- Universidade Estadual de Londrina, CEPPOS - Centro de Pós-Graduação Professor Dr. Darli Antonio Soares, Av. Robert Koch, 60 - Vila Operária, Londrina, Paraná, Brazil
| | - Dirce Shizuko Fujisawa
- Universidade Estadual de Londrina, CEPPOS - Centro de Pós-Graduação Professor Dr. Darli Antonio Soares, Av. Robert Koch, 60 - Vila Operária, Londrina, Paraná, Brazil
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Resistance Training as a Countermeasure for Key Non-communicable Diseases in Low-Resource Settings: A Review. Asian J Sports Med 2020. [DOI: 10.5812/asjsm.106588] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background: Non-communicable diseases (NCDs) are responsible for 60% of global deaths. Of these NCD-attributable deaths, about 80% are in low- to middle-income countries (LMICs). The role of exercise in major NCDs is evident; however, popular and cost-effective aerobic modes of exercise, such as walking, consistently do not meet minimum intensity guidelines for health improvement. Interestingly, low-cost resistance training (using callisthenics, Pilates, elastic tubing, etc.) has proven equally effective to conventional resistance training using weight machines in improving several health parameters related to NCDs, although their effectiveness in LMICs is not as well documented as in high-income countries (HICs). Objectives: This review aimed to examine low-cost approaches of resistance training to health promotion, NCD risk reduction, and NCD rehabilitation/management to mitigate the epidemic of NCDs in lower-resource settings. Methods: An electronic search was performed on the following databases from inception until December 2019: PubMed/Medline, Sport Discuss, Embase, Science Direct, Current Contents, CISTI Source, Google Scholar, Cochrane Library, Cochrane Database of Systematic Reviews, CINAHL EBM Reviews, and international e-catalogues. Results: Data on resistance training provision cost in low-resource settings indicates that it is not reasonable to use this mode of training in low-resource settings in the same way as it is used in high-resource ones. This review summarized some strategies which can be employed to ensure the delivery of all core resistance training components in low-resource settings. The data suggests that resistance training be adapted for delivery in non-clinical settings in LMICs. Conclusions: Program design variables of resistance training are similar in low- and well-resourced settings. However, only individuals with low-risk will be able to perform exercise without adverse consequences in home-based settings. Health care practitioners in LMICs should take an active role in promoting resistance training when promoting health, reducing NCD risk, and NCD rehabilitation.
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10
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Nazari M, Shabani R, Dalili S. The effect of concurrent resistance-aerobic training on serum cortisol level, anxiety, and quality of life in pediatric type 1 diabetes. J Pediatr Endocrinol Metab 2020; 33:599-604. [PMID: 32284450 DOI: 10.1515/jpem-2019-0526] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/24/2020] [Indexed: 02/01/2023]
Abstract
Background Given the importance of anxiety and quality of life for the mental health of children with type 1 diabetes (T1D), exercise prescription can be of crucial significance. The present study aims to explore the effect of concurrent resistance-aerobic training on serum cortisol level, anxiety, and quality of life among pediatric T1D. Methods Forty children (aged 8-14 years) were randomly assigned to experimental (n = 20) and control groups (n = 20) for 16 weeks. The exercise training program was composed of 16 weeks of interval concurrent resistance-aerobic training with a duration of 60 min performed three times a week. The subjects first performed the resistance training (20 min of Pilates exercises and 20 min of body weight-bearing exercises). Then, the aerobic exercises were performed with an intensity of 50-75% of maximum heart rate. Before and after the training, blood tests including cortisol were carried out on the subjects by RIA kit. Anxiety and quality of life were measured by the Revised Children's Manifest Anxiety Scale (RCMAS) and Pediatric Quality of Life (PedsQL), respectively. Body composition was measured by InBody. Data were analyzed by paired and independent t-test at p < 0.05 significance level. Results Sixteen weeks of concurrent resistance-aerobic exercise significantly reduced the anxiety index (p = 0.001) and increased the quality of life (p = 0.003). Although the cortisol index was increased, it did not reveal any significant differences between the experimental and control groups (p = 0.781). No significant differences were observed in the indices of quality of life, anxiety, and cortisol in the control group. Conclusions A 16-week program of concurrent resistance-aerobic training can improve the quality of life and anxiety among children suffering from T1D, but it may not influence the cortisol level (p > 0.05).
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Affiliation(s)
- Marzieh Nazari
- PhD Candidate of Exercise Physiology, Faculty of Humanities, Rasht Brunch, Islamic Azad University, Rasht, Iran.,Young Researchers and Elite Club, Rasht Brunch, Islamic Azad University, Rasht, Iran
| | - Ramin Shabani
- Associate Professor, Department of Exercise, Physiology, Faculty of Humanities, Rasht Brunch, Islamic Azad University, Rasht 147654919, Iran, Phone: (+98) 9112324796, 1333424309
| | - Setila Dalili
- Department of Pediatric Endocrinology, Pediatric Growth Disorders Research Center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, IR Iran
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11
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Martínez-Sánchez SM, Martínez-García TE, Bueno-Antequera J, Munguía-Izquierdo D. Feasibility and effect of a Pilates program on the clinical, physical and sleep parameters of adolescents with anorexia nervosa. Complement Ther Clin Pract 2020; 39:101161. [PMID: 32379690 DOI: 10.1016/j.ctcp.2020.101161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 02/20/2020] [Accepted: 03/27/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE Anorexia nervosa (AN) becomes chronic, with high physical, psychological and social morbidity and high mortality without early and effective treatment. The impact of physical exercise as a coadjutant to conventional treatment in this clinical population has been studied with favorable results. Although a Pilates program could be beneficial for patients with AN, no study has analyzed its feasibility and effects in adolescents with AN. Therefore, this study evaluated the safety of a Pilates program and investigated the feasibility and effect in adolescents with AN. MATERIALS AND METHODS In this prospective quasi-experimental study, body composition, blood analysis, sedentary time, physical activity and time of sleep, and physical fitness were measured objectively before and after a 10-week Pilates supervised program. RESULTS Twelve female adolescents with AN (14.6 ± 1.7 years old) completed the program, with a session attendance rate of 96%, a persistence rate of 100%. There were significant increases in height, plasma calcium and sleep efficiency. Significant decreases in plasma follitropin, sleep duration and, duration and number of night perturbations were observed. CONCLUSION A Pilates program is safe and feasible in adolescents with AN when they have a controlled and stable weight, and such a program could be a viable alternative among treatment programs to achieve better sleep quality.
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Affiliation(s)
- Sofía M Martínez-Sánchez
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain.
| | | | - Javier Bueno-Antequera
- Physical Performance Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain.
| | - Diego Munguía-Izquierdo
- Physical Performance Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain; Biomedical Research Networking Center on Frailty and Healthy Aging, Madrid, Spain.
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12
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Qadir KJ, Zangana KO. Effect of swimming program on glycemic control in male adolescents with type 1 diabetes mellitus. J Sports Med Phys Fitness 2020; 60:302-307. [PMID: 31958000 DOI: 10.23736/s0022-4707.19.10053-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Regular physical activity and exercise is the third management for the child with diabetes mellitus after diet regime and insulin therapy. The aim of the study is to evaluate the effect of swimming on glycemic control for a male adolescent with type 1 diabetes mellitus. The study evaluates the effect of swimming on glycemic control for a male adolescent with type 1 diabetes mellitus. METHODS The quasi-experimental design was conducted on 40 male adolescents with typ1 diabetes, then divided into two groups; study and control groups. 20 adolescents participated in the swimming program (study group) and other 20 did not expose to exercise program (control group) for 10 weeks. a venous blood sample was received to evaluate glycemic control (HbA1c %), in pre and post 10 weeks to compare HbA1c % for both groups. RESULTS Mean age 13.45±1.46 years (study group), while for control group age 13.55±1.5 years, and mean and standard deviation for Hba1c % was 9.61±1.15%, 9.65±2.23% in the study and control group respectively. The study showed that there was a high significant difference between pre and post-test HbA1c in the study group (P value<0.00) also the same result was observed in the control group but negatively (P value<0.00) it means the Hb1c % was raised. CONCLUSIONS The study concluded that regular physical activity (swimming) had a positive effect on lowering Glycosylated hemoglobin (HbA1c).
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Affiliation(s)
- Kaify J Qadir
- Department of Pediatric Nursing Science, Hawler Medical University College of Nursing, Erbil, Iraq -
| | - Kawes O Zangana
- Departmeny of Pediatric Medicine, Hawler Medical University College of Medicine, Erbil, Iraq
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13
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Absil H, Baudet L, Robert A, Lysy PA. Benefits of physical activity in children and adolescents with type 1 diabetes: A systematic review. Diabetes Res Clin Pract 2019; 156:107810. [PMID: 31401153 DOI: 10.1016/j.diabres.2019.107810] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 08/06/2019] [Indexed: 12/27/2022]
Abstract
AIMS We performed a systematic review of clinical trials investigating the health benefits of physical activity in pediatric patients with type 1 diabetes. METHODS To perform this systematic review, search strategies were created and adapted to four databases. Only randomized controlled trials written in English before 1998 and that answered to the PICOS criteria were included. The PRISMA guidelines were followed to ensure highest scientific rigor within studies. RESULTS Seven studies out of 2655 were included in this systematic review according to the inclusion criteria. These studies showed positive gains on global health: blood lipid profile, physical fitness, quality of life and body size and body composition but only one demonstrated a positive effect on glycemic control. CONCLUSION Globally, physical activity exerts a positive impact on metabolic (i.e., decrease in total cholesterol, improvement of physical fitness, etc.) and psychological health in children with type 1 diabetes. Yet variations in study protocols or sample size restrict statistical power to reach the outcome of improving glycemic control in most studies. Here, we address the measured outcomes in individual trials and discuss potential key elements to consider for future clinical trials.
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Affiliation(s)
- Hélène Absil
- Unité d'Endocrinologie Pédiatrique, Cliniques universitaires Saint Luc, Belgium
| | - Lia Baudet
- Unité d'Endocrinologie Pédiatrique, Cliniques universitaires Saint Luc, Belgium
| | | | - Philippe A Lysy
- Unité d'Endocrinologie Pédiatrique, Cliniques universitaires Saint Luc, Belgium; Pôle PEDI, Institut de Recherche Expérimentale et Clinique, UCLouvain, Av. Hippocrate 10, B-1200 Brussels, Belgium.
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14
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Hornsby E, Johnston LM. Effect of Pilates Intervention on Physical Function of Children and Youth: A Systematic Review. Arch Phys Med Rehabil 2019; 101:317-328. [PMID: 31152703 DOI: 10.1016/j.apmr.2019.05.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/01/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To conduct a systematic review to evaluate the effectiveness of Pilates intervention on physical function in children and youth. DATA SOURCES Six electronic databases were searched from inception to June 2018 using the term Pilates. STUDY SELECTION Articles were included if they (1) reported original data for a Pilates-only intervention; (2) involved children or youth aged up to 22 years; (3) reported a musculoskeletal, pain, or function study outcome. Searches identified 2565 papers and 11 studies fulfilled the inclusion criteria. DATA EXTRACTION The 2 authors independently screened and assessed all studies and any discrepancies were resolved by consensus. DATA SYNTHESIS Level of evidence was classified using the Oxford Centre for Evidence Based Medicine. Study quality was assessed using the Physiotherapy Evidence Database for randomized controlled trials and Risk of Bias in N-of-1 Trials scale for single case experimental design studies. Four studies were high quality, 3 were fair quality, and 4 were of low quality. Findings showed that Pilates does appear to improve flexibility (n=6); muscle strength, power and movement speed (n=3); postural control, orientation and balance (n=3); metabolic cost (n=1); functional ability (n=1) and health related quality of life (n=1) and reduce pain (n=2) in children with musculoskeletal pathology, the majority with a large effect size. Pilates content varied from group-based mat classes to individualized programs using specialized equipment. Intervention dose and frequency varied widely. CONCLUSIONS This is the first systematic review of the effect of Pilates intervention for children and youth. Research is in the preliminary stages; however, Pilates does appear to improve flexibility, strength and postural control, and reduce pain in children with musculoskeletal pathology. Further research is warranted to determine the potential effectiveness of Pilates for children and youth for various population groups and to develop comprehensive treatment guidelines.
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Affiliation(s)
- Elizabeth Hornsby
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; Kids Care Physiotherapy, Brisbane, Australia.
| | - Leanne M Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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15
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Cardiovascular Health Benefits of Exercise Training in Persons Living with Type 1 Diabetes: A Systematic Review and Meta-Analysis. J Clin Med 2019; 8:jcm8020253. [PMID: 30781593 PMCID: PMC6406966 DOI: 10.3390/jcm8020253] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/07/2019] [Accepted: 02/13/2019] [Indexed: 02/07/2023] Open
Abstract
Exercise is advocated in the management of type 1 diabetes (T1D), but the effects of different forms of exercise training on cardiovascular risk factors in T1D still remain unclear. The aim of this study was to conduct a systematic review and meta-analysis on exercise training for cardiovascular risk factors in T1D. Six electronic databases were systematically searched for randomized or non-randomized controlled studies reporting associations between exercise training and cardiovascular risk factors in T1D. Weighted mean differences (WMD) of each cardiovascular risk factor between exercise groups and control groups were calculated using a random effects model. A total of 24 studies reported the effects of exercise training on cardiovascular risk factors. Exercise training increased maximal aerobic power (3.01 mL·kg−1·min−1, 95% confidence interval, CI, 0.94 to 6.38) and reduced glycated hemoglobin (HbA1c; −0.45%, 95% CI −0.73 to −0.17), daily insulin dosage (−0.88 U·kg−1, 95% CI −1.27 to −0.48), and total cholesterol (−0.38 mmol·L−1, 95% CI −0.71 to −0.04). Exercise training did not lead to consistent changes in body mass index (BMI), blood pressure, triglycerides, high-density lipoprotein cholesterol (HDL-C), or low-density lipoprotein cholesterol (LDL-C). In persons living with T1D, exercise training is associated with a beneficial cardiovascular profile, including improvements in lipid profile, glycemic control (decreased daily insulin dosage and HbA1c), and aerobic fitness.
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16
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Klaprat N, MacIntosh A, McGavock JM. Gaps in Knowledge and the Need for Patient-Partners in Research Related to Physical Activity and Type 1 Diabetes: A Narrative Review. Front Endocrinol (Lausanne) 2019; 10:42. [PMID: 30787908 PMCID: PMC6372552 DOI: 10.3389/fendo.2019.00042] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/17/2019] [Indexed: 12/12/2022] Open
Abstract
Regular physical activity (PA) is a cornerstone in the management of complications associated with type 1 diabetes (T1D). Most national guidelines advocate for regular PA for persons living with T1D, however the evidence to support these recommendations has not be reviewed recently. Additionally, in an era of patient-centered care and patient oriented research, the role of patient partners in the area of PA and T1D interventions has never been explored. The purpose of this narrative review is to overcome these two gaps in the literature. Here we review selected epidemiological evidence and identify gaps in research that would add important information to guide practitioners and future guidelines. We also provide an overview of patient-oriented research projects co-developed with persons living with T1D. Significant gaps in the field include: (1) a lack of adequately powered prospective cohort studies using serial measures of PA and hard chronic disease end-points; (2) no multi-centered, highly powered, randomized controlled trials of PA, and long-term health outcomes; (3) little data on the role of new technologies to support PA-related behavior change, and (4) no trials that involved patients in the design and execution of PA-based clinical trials. This review provides a template for scientists and patient partners to develop future research priorities and agendas in the field.
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Affiliation(s)
- Nika Klaprat
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Andrea MacIntosh
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jonathan M. McGavock
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Diabetes Action Canada SPOR Network, Toronto, ON, Canada
- *Correspondence: Jonathan M. McGavock
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17
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Miranda S, Marques A. Pilates in noncommunicable diseases: A systematic review of its effects. Complement Ther Med 2018; 39:114-130. [PMID: 30012382 DOI: 10.1016/j.ctim.2018.05.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/31/2018] [Accepted: 05/31/2018] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES Chronic cardiovascular diseases, cancer, chronic respiratory diseases and diabetes are the four major groups of non-communicable diseases (NCDs) and the main cause of mortality worldwide. Pilates has been described as an effective intervention to promote healthy behaviors and physical activity in people with chronic diseases. However, the evidence of its effects in NCDs have not been systematized. We investigated the effects of Pilates in the four major groups of NCDs. DESIGN A systematic review was performed. Searches were conducted on Cochrane Library, EBSCO, PubMed, Science Direct, Scopus and Web of Science databases. Studies were rated with the quality assessment tool for quantitative studies. As a meta-analysis was not possible to conduct, a best-evidence synthesis was used. RESULTS Twelve studies, mostly of moderate quality, were included with 491 participants (78.6% females; age range 13-70 years old) with breast cancer (n = 3), diabetes (n = 3), chronic stroke (2 years post stroke) (n = 2), chronic obstructive pulmonary disease (n = 1), cystic fibrosis (n = 1), heart failure (n = 1) and arterial hypertension (n = 1). The best-evidence synthesis revealed strong evidence for improving exercise tolerance; moderate evidence for improving symptoms, muscle strength and health-related quality of life and limited or conflicting evidence on vital signs, metabolic parameters, body composition, respiratory function, functional status, balance, flexibility and social support. CONCLUSIONS Pilates should be considered for patients with NCDs, as it improves exercise tolerance. Future studies with robust methodologies are still needed to clarify its effectiveness on outcomes with moderate, limited or conflicting evidence and to establish the most suitable intervention protocol.
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Affiliation(s)
- Sara Miranda
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute for Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal.
| | - Alda Marques
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute for Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal.
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18
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Mohamed MT, Embaby EA, Labib A, El-Husseiny M, Khamis H, El-Demery A, Shoukry MM. Effects of exercise in combination with autologous bone marrow stem cell transplantation for patients with type 1 diabetes. Physiother Theory Pract 2018; 35:1233-1242. [PMID: 29775119 DOI: 10.1080/09593985.2018.1474511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Stem cell therapy is a promising approach for the treatment of type 1 diabetes mellitus (T1D). Previous studies recommended regular exercise for the control of T1D. Experimental studies showed that a combination of stem cells and exercise yielded a better outcome. Yet, the effect of exercise programs following stem cell transplantation in patients with T1D has not been investigated. Thus, the current study aimed to examine the effect of a combined exercise program on measures of glycemic control in patients with T1D who received autologous bone marrow stem cell transplantation (ABMSCT). Thirty patients with controlled T1D were assigned into two equal groups. Both groups underwent ABMSCT and received insulin therapy and a diabetic diet regime. Only the exercise group followed the combined exercise program. Outcome measures of glycemic control (i.e. fasting blood glucose level [FBG], post-prandial blood glucose level [PPG], HbA1c, daily insulin dosage, and C-peptide levels) were tested before and after a 3-month rehabilitation period. There were significant (p < 0.05) decreases in all outcome measures except C-peptides after ABMSCT compared with before in both groups. Moreover, there was a significant decrease in the mean value of HbA1c in the exercise group compared with the control group after rehabilitation. Overall, this study strengthens the idea that adding exercise to ABMSCT is important to help control diabetes in patients with T1D.
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Affiliation(s)
- Marwa Taher Mohamed
- Department of Basic Science, Faculty of Physical Therapy, Cairo University, Giza, Egypt.,Department of Physical Therapy, Wadi El-Neel Hospital, Cairo, Egypt
| | - Eman Ahmed Embaby
- Department of Basic Science, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Awatif Labib
- Department of Basic Science, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | | | - Hazem Khamis
- Department of Cardiology, 6th October University, Giza, Egypt
| | - Ahmed El-Demery
- Department of Medical Biocemistry, 6th October University, Elmehawar Almarkazy, Giza, Egypt
| | - Mohamed Mounir Shoukry
- Faculty of Pharmacy, MTI University, Cairo, Egypt.,Department of Pharmacology, Wadi El-Neel Hospital, Cairo, Egypt
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19
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Mitchell F, Wilkie L, Robertson K, Reilly JJ, Kirk A. Feasibility and pilot study of an intervention to support active lifestyles in youth with type 1 diabetes: The ActivPals study. Pediatr Diabetes 2018; 19:443-449. [PMID: 29171135 DOI: 10.1111/pedi.12615] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 10/24/2017] [Accepted: 11/06/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Evidence suggests youth with type 1 diabetes (T1D) have lower levels of physical activity (PA) than the general population. The ActivPals intervention aimed to support youth with T1D to lead an active lifestyle. METHODS Twenty youth aged 7 to 16 years with T1D were recruited to a pilot randomized controlled trial. PA and quality of life (QoL) were measured using Actigraph GT3X+ monitor and Pediatric QoL scales at baseline and 1-month follow-up. A two-way, mixed ANOVA showed indicative effects of the intervention. Qualitative interviews were carried out with 16 participants to explore perceptions of the intervention. RESULTS An increase in moderate to vigorous PA was reported in intervention and control groups from baseline to follow-up (F(1, 14) = 5.83; P = .03), with no significance between group differences. Participants in both groups reported significantly less overall diabetes "problems" (F(1, 16) = 7.93; P = .012) and significantly less lifestyle "problems" (F(1, 16) = 7.39; P = .015) at follow-up. However, both groups also reported significant increases in "problems" with the day-to-day diabetes routine (F(1,16) = 6.48; P = .022) at follow-up. Parents reported significant increased worry about their child's diabetes at follow-up, in both groups (F(1, 14) = 5.83; P = .046). There was no significant increase in reported hypoglycemic occurrences despite increased PA. The qualitative data highlight that goal setting, self-monitoring, and social support were effective motivators for increasing PA. CONCLUSIONS A larger trial with longer follow-up should be conducted to explore the effect of the intervention on PA in youth with T1D.
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Affiliation(s)
- Fiona Mitchell
- Physical Activity for Health Group, University of Strathclyde, Glasgow, Scotland, UK
| | | | - Kenneth Robertson
- Children's Diabetes Service, Greater Glasgow and Clyde, Yorkhill Hospital, Glasgow, Scotland, UK
| | - John J Reilly
- Physical Activity for Health Group, University of Strathclyde, Glasgow, Scotland, UK
| | - Alison Kirk
- Physical Activity for Health Group, University of Strathclyde, Glasgow, Scotland, UK
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20
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Ostman C, Jewiss D, King N, Smart NA. Clinical outcomes to exercise training in type 1 diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract 2018; 139:380-391. [PMID: 29223408 DOI: 10.1016/j.diabres.2017.11.036] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 08/25/2017] [Accepted: 11/28/2017] [Indexed: 12/17/2022]
Abstract
AIMS To establish the relationship between exercise training and clinical outcomes in people with type I diabetes. METHODS Studies were identified through a MEDLINE search strategy, Cochrane Controlled Trials Registry, CINAHL, SPORTDiscus and Science Citation Index. The search strategy included a mix of key concepts related to trials of exercise training in people with type 1 diabetes; glycaemic control. Searches were limited to prospective randomized or controlled trials of exercise training in humans with type 1 diabetes lasting 12 weeks or more. RESULTS In exercised adults there were significant improvements in body mass Mean Difference (MD): -2.20 kg, 95% Confidence Interval (CI) -3.79-0.61, p = .007; body mass index (BMI) MD: -0.39 kg/m2, 95% CI -0.75-0.02, p = .04; Peak VO2 MD: 4.08 ml/kg/min, 95% CI -2.18-5.98, p < .0001; and, low-density lipoprotein cholesterol (LDL) MD: -0.21 mmol/L, 95% CI -0.33-0.08, p = .002. In exercised children there were significant improvements in insulin dose MD: -0.23 IU/kg, 95% CI -0.37-0.09, p = .002; waist circumference MD: -5.40 cm, 95% CI -8.45 to -2.35, p = .0005; LDL MD: -0.31 mmol/L, 95% CI -0.55 to -0.06, p = .02; and, triglycerides MD: -0.21 mmol/L, 95% CI -0.42 to -0.01, p = .04. There were no significant changes in glycosylated haemoglobin (HbA1C%), fasting blood glucose, resting heart rate, resting systolic blood pressure or high density lipoproteins in either group. CONCLUSIONS Exercise training improves some markers of type 1 diabetes severity; particularly body mass, BMI, Peak VO2 and LDL in adults and insulin dose, waist circumference, LDL and triglycerides in children.
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Affiliation(s)
- C Ostman
- Schools of Rural Medicine and Science and Technology, University of New England, Armidale, NSW 2351, Australia
| | - D Jewiss
- Schools of Rural Medicine and Science and Technology, University of New England, Armidale, NSW 2351, Australia
| | - N King
- School of Biomedical and Healthcare Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth PL4 8AA, UK
| | - N A Smart
- Schools of Rural Medicine and Science and Technology, University of New England, Armidale, NSW 2351, Australia.
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21
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Codella R, Terruzzi I, Luzi L. Why should people with type 1 diabetes exercise regularly? Acta Diabetol 2017; 54:615-630. [PMID: 28289908 DOI: 10.1007/s00592-017-0978-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 02/27/2017] [Indexed: 01/09/2023]
Abstract
Plethoric evidence reminds of the protective effects of exercise against a number of health risks, across all ages, in the general population. The benefits of exercise for individuals with type 2 diabetes are indisputable. An in-depth understanding of energy metabolism has reasonably entailed exercise as a cornerstone in the lifestyle of almost all subjects with type 1 diabetes. Nevertheless, individuals with type 1 diabetes often fail in accomplishing exercise guidelines and they are less active than their peer without diabetes. Two major obstacles are feared by people with type 1 diabetes who wish to exercise regularly: management of blood glucose control and hypoglycemia. Nowadays, strategies, including glucose monitoring technology and insulin pump therapy, have significantly contributed to the participation in regular physical activity, and even in competitive sports, for people with type 1 diabetes. Novel modalities of training, like different intensity, interspersed exercise, are as well promising. The beneficial potential of exercise in type 1 diabetes is multi-faceted, and it has to be fully exploited because it goes beyond the insulin-mimetic action, possibly through immunomodulation.
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Affiliation(s)
- Roberto Codella
- Department of Biomedical Sciences for Health, University of Milan, Via F.lli Cervi 93, Segrate, 20090, Milan, Italy.
| | - Ileana Terruzzi
- Diabetes Research Institute, Metabolism, Nutrigenomics and Cellular Differentiation Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Livio Luzi
- Department of Biomedical Sciences for Health, University of Milan, Via F.lli Cervi 93, Segrate, 20090, Milan, Italy
- Metabolism Research Center, IRCCS Policlinico San Donato, San Donato Milanese, Italy
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Rahimimoghadam Z, Rahemi Z, Mirbagher Ajorpaz N, Sadat Z. Effects of Pilates exercise on general health of hemodialysis patients. J Bodyw Mov Ther 2017; 21:86-92. [DOI: 10.1016/j.jbmt.2016.05.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/04/2016] [Accepted: 05/24/2016] [Indexed: 10/21/2022]
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Mitchell F, Kirk A, Robertson K, Reilly JJ. Development and feasibility testing of an intervention to support active lifestyles in youths with type 1 diabetes-the ActivPals programme: a study protocol. Pilot Feasibility Stud 2016; 2:66. [PMID: 27965881 PMCID: PMC5153684 DOI: 10.1186/s40814-016-0106-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 10/20/2016] [Indexed: 01/25/2023] Open
Abstract
Background The global incidence of type 1 diabetes is rising, and youths with type 1 diabetes continue to suffer poorer health than peers without diabetes. Evidence suggests youths with type 1 diabetes have physical activity (PA) levels well below the recommendations for health and have high levels of sedentary behaviour. An active lifestyle is therefore recommended to improve health. There is limited research showing effective lifestyle behaviour change in this population; therefore, an evidence gap exists between the need to promote physical activity in type 1 diabetes care and lack of understanding on how to do this. This protocol paper describes a feasibility and pilot study of the ActivPals programme—an intervention to support active lifestyles in youths with type 1 diabetes. Methods/design Key intervention components have been identified from preliminary work (individual and family focus, peer mentoring, technology integration and improved communication and understanding) and are being developed into a pragmatic randomised controlled trial (RCT) supported by recruitment pathways. A steering group of health care professionals and managers will refine the intervention to patient needs. A pilot trial is providing data on intervention implementation, acceptability and feasibility. Twenty youths with type 1 diabetes are being recruited and randomised into an intervention or control group. Physical activity is being measured objectively using the Actigraph GT3X+ monitor at baseline and 1-month follow-up. Contextual factors associated with intervention delivery are being explored. Discussion This study will contribute to the development of evidence-based, user-informed and pragmatic interventions leading to healthier lifestyles in youths with type 1 diabetes.
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Affiliation(s)
- Fiona Mitchell
- Physical Activity and Health Group, University of Strathclyde, Glasgow, Scotland
| | - Alison Kirk
- Physical Activity and Health Group, University of Strathclyde, Glasgow, Scotland
| | - Kenneth Robertson
- Children's Diabetes Service, Greater Glasgow and Clyde, Yorkhill Hospital, Glasgow, Scotland
| | - John J Reilly
- Physical Activity and Health Group, University of Strathclyde, Glasgow, Scotland
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Abstract
Youth with type 1 diabetes are at risk for developing cardiovascular disease, and regular physical activity is strongly recommended as one strategy for prevention, as well as for good glycemic control. Despite recommendations, families in this pediatric population face unique barriers to physical activity, including fear of hypoglycemia. Moreover, families are not routinely counseled in the specific health and psychosocial benefits of following physical activity recommendations for youth with type 1 diabetes. To bridge this gap, the recent literature regarding physical activity in children with type 1 diabetes is reviewed with particular focus on young children. A discussion of the limitations of the current body of research, and recommendations for objectively measured physical activity are provided. Specific recommendations for clinical practice are given, including provider endorsements for regular physical activity for longer than 60 minutes, at least three times a week.
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Affiliation(s)
- Carrie Tully
- Center for Translational Research, Children's National Medical Center, 111 N. Michigan Avenue, NW, Washington, DC, 20010, USA.
| | - Laura Aronow
- Center for Translational Research, Children's National Medical Center, 111 N. Michigan Avenue, NW, Washington, DC, 20010, USA
| | - Eleanor Mackey
- Center for Translational Research, Children's National Medical Center, 111 N. Michigan Avenue, NW, Washington, DC, 20010, USA
- Department of Pediatrics, George Washington University School of Medicine, Washington, DC, USA
| | - Randi Streisand
- Center for Translational Research, Children's National Medical Center, 111 N. Michigan Avenue, NW, Washington, DC, 20010, USA
- Department of Pediatrics, George Washington University School of Medicine, Washington, DC, USA
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Kamioka H, Tsutani K, Katsumata Y, Yoshizaki T, Okuizumi H, Okada S, Park SJ, Kitayuguchi J, Abe T, Mutoh Y. Effectiveness of Pilates exercise: A quality evaluation and summary of systematic reviews based on randomized controlled trials. Complement Ther Med 2016; 25:1-19. [DOI: 10.1016/j.ctim.2015.12.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 12/10/2015] [Accepted: 12/29/2015] [Indexed: 11/28/2022] Open
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Pilates-Based Mat Exercises and Parameters of Quality of Life in Women With Type 2 Diabetes. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016. [DOI: 10.5812/ircmj.21919] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Rees J, Gaida JE, Silbernagel KG, Zwerver J, Anthony JS, Scott A. Rehabilitation of Tendon Problems in Patients with Diabetes Mellitus. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 920:199-208. [PMID: 27535262 DOI: 10.1007/978-3-319-33943-6_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Exercise is crucial in the management of diabetes mellitus and its associated complications. However, individuals with diabetes have a heightened risk of musculoskeletal problems, including tendon pathologies. Diabetes has a significant impact on the function of tendons due to the accumulation of advanced glycation end-products in the load-bearing collagen. In addition, tendon vascularity and healing may be reduced due to diabetes-induced changes in the peripheral vascular system, and impaired synthesis of collagen and glycosaminoglycan. The current chapter presents an evidence-based discussion of considerations for the rehabilitation of tendon problems in people with diabetes. The following conditions are discussed in detail - calcific tendinopathy, tenosynovitis, tendon rupture, and non-calcifying tendinopathy. Common diabetes-related findings are presented, along with their potential impact on tendinopathy management and suggested modifications to standard tendinopathy treatment protocols. A holistic approach should be used to optimize musculotendinous function, including a comprehensive exercise prescription addressing strength, flexibility, and aerobic fitness.
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Affiliation(s)
- Jonathan Rees
- Department of Rheumatology, Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK
- Academic Department of Sport and Exercise Medicine, Queen Mary College, London, UK
- Department of Sport and Exercise Medicine, Fortius Clinic, London, UK
| | - Jamie E Gaida
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Discipline of Physiotherapy, University of Canberra, Canberra, ACT, Australia
| | | | - Johannes Zwerver
- Center for Sports Medicine, UMC Groningen, 30.001, 9700, RB Groningen, The Netherlands
| | - Joseph S Anthony
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Alex Scott
- Department of Physical Therapy, Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada.
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28
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Effects of Nordic Walking and Pilates exercise programs on blood glucose and lipid profile in overweight and obese postmenopausal women in an experimental, nonrandomized, open-label, prospective controlled trial. Menopause 2015; 22:1215-23. [DOI: 10.1097/gme.0000000000000446] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Yardley J, Mollard R, MacIntosh A, MacMillan F, Wicklow B, Berard L, Hurd C, Marks S, McGavock J. Vigorous intensity exercise for glycemic control in patients with type 1 diabetes. Can J Diabetes 2015; 37:427-32. [PMID: 24321725 DOI: 10.1016/j.jcjd.2013.08.269] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 08/13/2013] [Accepted: 08/26/2013] [Indexed: 12/17/2022]
Abstract
Regular physical activity has substantial health benefits in persons with type 1 diabetes, including reduced risk of complications and cardiovascular mortality as well as improved self-rated quality of life. Despite these benefits, individuals with type 1 diabetes are often less active than their peers without diabetes. When factors such as time constraints, work pressure and environmental conditions are often cited as barriers to physical activity in the general population, 2 additional major factors may also explain the low rates of physical activity in young people with type 1 diabetes: (1) fear of hypoglycemia both during and after (particularly overnight) exercise and (2) a lack of empiric evidence for the efficacy of physical activity for achieving optimal glycemic control. A number of acute exercise trials recently showed that the inclusion of vigorous intensity physical activity in conventional moderate intensity (i.e. walking and light cycling) exercise sessions may overcome these barriers. No studies have tested the efficacy of high-intensity physical activity on glycemic control (A1C) or post-exercise hypoglycemia in a randomized controlled trial. This article summarizes the literature related to the role of physical activity for the management of blood glucose levels in individuals with type 1 diabetes and provides a rationale for the need of a randomized controlled trial examining the effects of vigorous-intensity physical activity on blood glucose control.
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Affiliation(s)
- Jane Yardley
- Manitoba Institute of Child Health, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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Lukács A, Barkai L. Effect of aerobic and anaerobic exercises on glycemic control in type 1 diabetic youths. World J Diabetes 2015; 6:534-542. [PMID: 25897363 PMCID: PMC4398909 DOI: 10.4239/wjd.v6.i3.534] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 12/08/2014] [Accepted: 01/19/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To evaluate the long-term effect of aerobic and/or anaerobic exercise on glycemic control in youths with type 1 diabetes.
METHODS: Literature review was performed in spring and summer 2014 using PubMed/MEDLINE, Google Scholar, Scopus, and ScienceDirect with the following terms: aerobic, anaerobic, high-intensity, resistance, exercise/training, combined with glycemic/metabolic control, glycated haemoglobin A1c (HbA1c) and type 1 diabetes. Only peer-reviewed articles in English were included published in the last 15 years. It was selected from 1999 to 2014. Glycemic control was measured with HbA1c. Studies with an intervention lasting at least 12 wk were included if the HbA1c was measured before and after the intervention.
RESULTS: A total of nine articles were found, and they were published between the years of 2002-2011. The sample size was 401 diabetic youths (166 males and 235 females) with an age range of 10-19 years except one study, in which the age range was 13-30 years. Study participants were from Australia, Tunisia, Lithuania, Taiwan, Turkey, Brazilia, Belgium, Egypt and France. Four studies were aerobic-based, four were combined aerobic and anaerobic programs, and one compared aerobic exercise to anaerobic one. Available studies had insufficient evidence that any type of exercise or combined training would clearly improve the glycemic control in type 1 diabetic youth. Only three (two aerobic-based and one combined) studies could provide a significant positive change in glycemic control.
CONCLUSION: The regular physical exercise has several other valuable physiological and health benefits that justify the inclusion of exercise in pediatric diabetes treatment and care.
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Quirk H, Blake H, Tennyson R, Randell TL, Glazebrook C. Physical activity interventions in children and young people with Type 1 diabetes mellitus: a systematic review with meta-analysis. Diabet Med 2014; 31:1163-73. [PMID: 24965376 PMCID: PMC4232875 DOI: 10.1111/dme.12531] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 03/19/2014] [Accepted: 06/20/2014] [Indexed: 12/27/2022]
Abstract
AIMS To synthesize evidence from randomized and non-randomized studies of physical activity interventions in children and young people with Type 1 diabetes so as to explore clinically relevant health outcomes and inform the promotion of physical activity. METHOD We conducted a search of CINAHL Plus, the Cochrane Library, EMBASE, MEDLINE, PsycINFO, SCOPUS, SportDiscus and Web of Science between October and December 2012. Eligible articles included subjects aged ≤18 years with Type 1 diabetes and a physical activity intervention that was more than a one-off activity session. Physiological, psychological, behavioural or social outcomes were those of interest. RESULTS A total of 26 articles (10 randomized and 16 non-randomized studies), published in the period 1964-2012, were reviewed. Although there was heterogeneity in study design, methods and reporting, 23 articles reported at least one significant beneficial health outcome at follow-up. Meta-analyses of these studies showed potential benefits of physical activity on HbA1c (11 studies, 345 participants, standardized mean difference -0.52, 95% CI -0.97 to -0.07; P = 0.02), BMI (four studies, 195 participants, standardized mean difference -0.41, 95% CI -0.70 to -0.12; P = 0.006) and triglycerides (five studies, 206 participants, standardized mean difference -0.70, 95% CI -1.25 to -0.14; P = 0.01).The largest effect size was for total cholesterol (five studies, 206 participants, standardized mean difference -0.91, 95% CI -1.66 to -0.17; P = 0.02). CONCLUSIONS Physical activity is important for diabetes management and has the potential to delay cardiovascular disease, but there is a lack of studies that are underpinned by psychological behaviour change theory, promoting sustained physical activity and exploring psychological outcomes. There remains a lack of knowledge of how to promote physical activity in people with Type 1 diabetes.
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Affiliation(s)
- H Quirk
- School of Health Sciences, University of Nottingham
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MacMillan F, Kirk A, Mutrie N, Matthews L, Robertson K, Saunders DH. A systematic review of physical activity and sedentary behavior intervention studies in youth with type 1 diabetes: study characteristics, intervention design, and efficacy. Pediatr Diabetes 2014; 15:175-89. [PMID: 23895512 DOI: 10.1111/pedi.12060] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 05/18/2013] [Accepted: 06/07/2013] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To systematically review physical activity and/or sedentary behavior intervention studies for youth with type 1 diabetes. METHODS Several databases were searched for articles reporting on randomized-controlled trials (RCTs) in youth (<18 yr) with type 1 diabetes. Data was extracted and bias assessed to evaluate study characteristics, intervention design, and efficacy of interventions on physical activity and health. Where sufficient data were available meta-analyses of health outcomes [for hemoglobin A1c (HbA1c)] were performed. Weighted mean differences (WMD) were calculated using fixed and random effect models. RESULTS The literature search identified 12/2397 full-text articles reporting on 11 studies. Two interventions were wholly unsupervised and only one was based on behavior change theory with no studies exploring changes in behavior processes. Nine interventions aimed to improve fitness or physical activity, two aimed to improve health, and none aimed at changing sedentary behavior. Eight interventions improved physical activity and/or fitness. At least one beneficial effect on health was found in each intervention group apart from two studies where no changes were found. Meta-analysis of 10 studies showed the interventions have a significant beneficial reduction of HbA1c (%), indicating an improvement in glycemic control [WMD, -0.85% (95% CI, -1.45 to -0.25%)]. There were insufficient data to pool other health outcome data. CONCLUSIONS Few RCTs explored the efficacy of unsupervised theory-based physical activity and/or sedentary behavior interventions in youth with type 1 diabetes. Limited reporting made comparison of findings challenging. There was an overall significant beneficial effect of physical activity on HbA1c.
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Affiliation(s)
- Freya MacMillan
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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